The issues of the unsustainable use of antibiotics has rumbled along in the background for many years with academic report after academic report highlighting that overuse and misuse is causing ‘super-bug’ bacteria to develop which is treatment resistant. However the calls of alarm have just got clearer and louder with the WHO producing its first ever report on resistance to antibiotics earlier this year stating that the crisis is bigger and more dangerous that AIDS.  The topic just won the public vote for the Horizon Longitude prize. Overuse of antibiotics is also now on the UK Risk Register, with England’s Chief Medical Officer describing it as a “ticking time bomb” and is as much a threat to the UK as terrorism.  Terrorism is an interesting analogy but perhaps the unsustainability of global natural, human and economic resource use is a much better comparison. In this regard, the wanton use of antibiotics is a perfect case study in dealing with unsustainability: and how we deal with this quantifiable and near term challenge will provide lessons for our other critical challenges

The hard bit about sustainably controlling our use of a desirable resource is that we have to forfeit some short-term human wellbeing satisfaction for much greater long term human wellbeing.  As research has shown we are not good accounting for the future and therefore the obscurities of the ‘who, what and when’ of blame and responsibility are a useful cover to excuse inaction. Antibiotics fall into this same trap – we know there is an issue but it is hard to pinpoint who is to blame, what actions are most critical and what, therefore, should be done by whom to stop the problem. Therefore it is very interesting that we seem to now have reached a consensus around the crisis – and watching the resulting actions unfold might tell us a lot about how we might step up action on the plethora of problems such as climate change, top soil erosion, biodiversity loss etc.  Similarly, working out why we have bungled our international climate change efforts should also help us in dealing with the antibiotics issue: antibiotics are a quick fix to a range of painful, uncomfortable and often potentially serious human problems – not unlike cheap energy.

Balancing the short and long term

There will be some quick wins in antibiotics (like with carbon reduction) e.g. educating people to finish their course, banning over the counter purchase, stopping access to them where the issue will quickly go away.  However, if these quick wins are not enough to stem the problem then there is a serious possibility that people in the next tranche of pain/ seriousness will have to be denied access. These people will have to suffer pain, have time off work, risk an infection getting much worse or risk passing this on to others.  It is at this point that decision makers will need to balance serious short-term human demands with even more serious long-term human needs – precisely what we are battling with in terms of use of carbon.  If they do not then WHO warns that in the relatively near future, people could die from minor scratches, burns or flu as superbugs spread and unlike Climate Change these effects will not be as easy for wealthy groups to hide from as desalination of water or air-conditioning (perhaps one of the reasons we might see clearer action on the problem).

International Cooperation

Antibiotics, like climate change, is absolutely a global problem.  This means that international cooperation to agree how to solve the problem is critical to its success. We have tried and failed on this front in terms of Climate Change – so will the issue of antibiotics fare any better and what lessons might we as the global community learn from that?  Like climate change this is recognised to require not just governments around the world but also global health systems and companies.

Technology may provide part of the answer, but just as with clean tech, questions of how to get affordable scalable solutions off the ground are abound. As recognised by the chair of MRSA Action UK suggested: “What is needed is for every Government across the world to subscribe to an international fund for the pharmaceutical industry to collaborate and work in partnership to develop these new antimicrobial solutions, including better diagnostics”. As also shown with Climate Change, the free market doesn’t work so well when it is responding to long-term challenges based on science.

Intergenerational Justice

So the antibiotic crisis is upon us – we saw it coming but unsurprisingly it appears only a crisis worse than AIDS will spur the international community to action.  The parallels to Climate Change are frightening and so for me at least there is a lot of hope bound up in our ability to come together to fight this properly – this will be a test of our ability to forfeit short-term gains, of our intelligence, our cooperation, our empathy and our concern for future generation.

“Antibiotics appear to be the most undervalued drug in our medical arsenal in terms of investment, but they are the most valuable one we have, if we ignore this problem any longer and bury our heads in the sand, we will leave ourselves not only in the dark ages as the Prime Minister has stated, we will for the first time in human history leave future generations in a worse position than our own” as said the MRSA UK chair.  Yes well, lets be fair this is just another example of this to add to the list….

Dr Victoria Hurth
Associate Professor in Marketing, Plymouth University
UK lead expert for ISO Sustainable Development in Communities
Board member of Tradable Energy Quotas

This article originally featured in the Croner Environment Magazine, reproduced with permission from Wolters Kluwer UK. Find out more

Image credit: Practical Cures on Flickr